What are diabetes problems?

Diabetes problems are health problems that can happen when you have diabetes. If your diabetes is not under control, you will have too much glucose*, also called sugar, in your blood. Having too much glucose in your blood for a long time can affect many important parts of your body, such as your

blood vessels and heart

nerves

kidneys

mouth

eyes

feet

You can do a lot to prevent or slow down these health problems if you keep your diabetes under control.

This chart shows the body parts that can be affected by diabetes and the resulting health problems you may have.

What should my blood glucose numbers be?

Your blood glucose numbers should meet the targets in this chart unless your doctor helps you set different targets. Targets are numbers you aim for. The chart shows the target blood glucose numbers—measured in milligrams per deciliter (mg/dL)—for most people with diabetes.

Target Blood Glucose Numbers (mg/dL)for Most People with Diabetes

Time of Day

Targets

Before meals and when you wake up

70 to 130

1 to 2 hours after eating

180 or below

This chart shows target blood glucose numbers for women with diabetes who become pregnant.

Severe hypoglycemia can cause you to pass out. If that happens, you’ll need help bringing your blood glucose level back to normal. Your health care team can teach your family members and friends how to give you an injection of glucagon, a medicine that raises blood glucose levels quickly. If glucagon is not available, someone should call 911 to get you to the nearest emergency room for treatment.

If you have any of these symptoms, check your blood glucose. If your number is too low, have one of these quick sources of glucose:

three or four glucose tablets

one serving of glucose gel—the amount equal to 15 grams of carbohydrates

1/2 cup, or 4 ounces, of any fruit juice

1/2 cup, or 4 ounces, of a regular—not diet—soft drink

1 cup, or 8 ounces, of milk

five or six pieces of hard candy

1 tablespoon of sugar or honey

Check your blood glucose again in 15 minutes to make sure it is at your pre-meal target number. If your number is still too low, have another serving of a quick glucose food or drink. Repeat these steps until your blood glucose is at your pre-meal target number or higher.

What is the A1C test?

The A1C test, also called the hemoglobin A1C test, HbA1C, or glycohemoglobin test, is a blood test that reflects the average level of glucose in your blood during the past 3 months. Your A1C test result is given in percents. Your doctor might use the A1C test to help diagnose your diabetes. Your doctor will draw a sample of your blood in the office or send you to a lab to have a sample of your blood drawn for the test. After being diagnosed with diabetes, you should have the A1C test at least twice a year.

Your A1C result plus your record of blood glucose numbers show whether your blood glucose is under control.

If your A1C result is too high, you may need to change your diabetes care plan. Your health care team can help you decide what part of your plan to change. For instance, you might need to change your meal plan, your diabetes medicines, or your physical activity plan.

If your A1C result is on target, then your diabetes treatment plan is working. The lower your A1C is, the lower your chance of having diabetes problems.

This chart shows the A1C goals for different types of people with diabetes.

Types of People

A1C Goals

Most people with diabetes

below 7%

Women with diabetes who want to getpregnant or who are pregnant

below 6%

A1C goals can also depend on

how long you have had diabetes

whether or not you have other health problems

Ask your doctor what goal is right for you.

This chart shows how your A1C result may match up to your average blood glucose number.

What should my blood pressure be?

Your blood pressure should be below 140/80 unless your doctor helps you set a different goal.

Blood pressure is the force of blood flow inside your blood vessels. Blood pressure is written with two numbers separated by a slash and is said as “140 over 80.” The top number is the pressure as your heart beats and pushes blood through your blood vessels. The bottom number is the pressure as your blood vessels relax between heartbeats.

Many people with diabetes also have high blood pressure. But keeping your blood pressure at your goal will help prevent damage to your heart, blood vessels, and other parts of your body. Healthy meal planning, medicines, and physical activity can help you reach your blood pressure goal.

What should my cholesterol and triglycerides be?

Your cholesterol and triglyceride numbers should meet the targets in this chart unless your doctor helps you set different targets.

Target Blood Cholesterol Numbersfor People with Diabetes

Total cholesterol

below 200

LDL, or bad, cholesterol

below 100 or below 70 if you have cardiovascular disease or other health problems

HDL, or good, cholesterol

above 40 in men and above 50 in women

Triglycerides

below 150

Cholesterol is a type of fat found in your body’s cells, in blood, and in many foods. High cholesterol can lead to heart and blood vessel disease, also called cardiovascular disease. Cardiovascular disease is the biggest health problem for people with diabetes.

LDL cholesterol. LDL cholesterol is known as the bad cholesterol because it builds up in the artery walls that supply blood to your heart. Extra cholesterol in your blood can build up in artery walls if

you often eat foods that are high in LDL cholesterol

high cholesterol runs in your family

HDL cholesterol. HDL cholesterol, or good cholesterol, carries cholesterol from other parts of your body back to your liver, which removes the cholesterol from your body.

Triglycerides. Triglycerides are another form of fat found in your blood and in food. Although triglycerides do not build up in artery walls, they can be a sign that your risk for cardiovascular disease is high.

Total cholesterol. Your total cholesterol number reflects all the cholesterol in the blood, but is mostly due to the amount of your LDL cholesterol.

Meeting your target numbers for cholesterol levels will help prevent heart disease, stroke, and damage to your blood vessels. Keeping cholesterol levels under control can also help with blood flow. Healthy meal planning, medicines, and physical activity can help you reach your target blood cholesterol numbers.

Have your cholesterol checked at least once a year. Your doctor will send you to a lab to have a small sample of your blood drawn for the cholesterol test. Ask your doctor whether you need medicine called a statin to control your cholesterol.

Will I need to take diabetes medicines?

If you cannot reach your target blood glucose levels with a healthy eating plan and physical activity, you may need diabetes medicines. The kind of medicines you’ll take will depend on your type of diabetes, your schedule, and your other health problems. Diabetes medicines help keep your blood glucose in the target range.

Your doctor will prescribe any medicines you need, including insulin. Insulin helps your blood glucose levels stay on target by moving glucose from your blood to your body’s cells. You will need to take insulin if your body no longer makes enough.

What steps can I take to prevent diabetes problems?

Follow the healthy eating plan that you and your doctor or dietitian have made.

Learn what to eat to keep your blood glucose levels under control.

Make wise food choices to help you feel good every day and to lose weight if needed.

Blood Glucose

Check your blood glucose every day.

Each time you check your blood glucose, write the number in a record book to share with your health care team.

Treat low blood glucose quickly.

Physical Activity

Even small amounts of physical activity help manage diabetes. Aim for 30 to 60 minutes of physical activity most days of the week. Children and adolescents with type 2 diabetes who are 10 to 17 years old should aim for 60 minutes of activity every day.

Not all physical activity has to take place at the same time.

Do aerobic activities, such as brisk walking, which use your large muscles to make your heart beat faster. The large muscles are those of the upper and lower arms and legs and those that control head, shoulder, and hip movements.

Do activities to strengthen muscles and bone, such as lifting weights or sit-ups. Aim for two times a week.

Increase daily activity by decreasing time spent watching TV or at the computer. Children and adolescents should limit screen time not related to school to less than 2 hours per day. Limiting screen time can help you meet your physical activity goal.

Always talk with your doctor before you start a new physical activity program.

Medicines

Take your medicines as directed, including insulin if ordered by your doctor.

How to Use the Daily Diabetes Record

This section provides a blank record where you can keep track of your blood glucose test results, medicines, and notes about things that affect your blood glucose. Make one copy of the record for each week. This record will help you see whether your diabetes plan is working. Review your record with your health care team at each checkup.

Follow this checklist when completing the daily diabetes record.

Blood Glucose Checks

Talk with your health care team about the best times to check your blood glucose—before meals, after meals, or at bedtime. Write when to check your blood glucose at the top of the chart.

Write down your target blood glucose numbers. If needed, record test results taken before and after a meal on either side of the line in the meal boxes. For instance,

Circle the blood glucose result each time you’re above or below your target. For instance,

Medicines

Under the heading marked “Medicines,” write the names of your diabetes medicines and the amounts taken.

Notes

Write down things that may affect your blood glucose numbers. Some examples are

eating more or less than usual

forgetting to take your diabetes medicines

physical activity—write down what kind and for how long

being sick

feeling upset about something—being under stress

Daily Diabetes Record

My Target Blood Glucose Numbers

Before meal target________ to ________1 to 2 hours after the start of a meal target________ or belowMy A1C target________

Acknowledgments

Publications produced by the Clearinghouse are carefully reviewed by both NIDDK scientists and outside experts. The National Diabetes Information Clearinghouse thanks the following people who helped review or field-test the original version of this publication:

National Diabetes Education Program

The National Diabetes Education Program is a federally funded program sponsored by the U.S. Department of Health and Human Services’ National Institutes of Health and the Centers for Disease Control and Prevention and includes over 200 partners at the federal, state, and local levels, working together to reduce the morbidity and mortality associated with diabetes.

National Diabetes Information Clearinghouse

The National Diabetes Information Clearinghouse (NDIC) is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK is part of the National Institutes of Health of the U.S. Department of Health and Human Services. Established in 1978, the Clearinghouse provides information about diabetes to people with diabetes and to their families, health care professionals, and the public. The NDIC answers inquiries, develops and distributes publications, and works closely with professional and patient organizations and Government agencies to coordinate resources about diabetes.

This publication is not copyrighted. The Clearinghouse encourages users of this publication to duplicate and distribute as many copies as desired.

This publication may contain information about medications and, when taken as prescribed, the conditions they treat. When prepared, this publication included the most current information available. For updates or for questions about any medications, contact the U.S. Food and Drug Administration toll-free at 1–888–INFO–FDA (1–888–463–6332) or visit www.fda.gov. Consult your health care provider for more information.